Partner-Oriented Drug Treatment and HIV Risk Reduction

描述（由申请人提供）：美沙酮维持治疗是一种有效的工具 减少注射吸毒者中艾滋病毒的风险和发病率。然而，很多时候， 接受美沙酮治疗的人继续使用鸦片剂和其他药物， 通常是与一个亲密的朋友或家庭成员目前没有登记在 治疗解决这个问题的一个办法是鼓励至少一名成员 美沙酮客户的个人吸毒网络也进入治疗， 从而减少出现吸毒机会的人数。 在这项先导研究中，268名美沙酮治疗新入组者（指数参与者） 将接受采访，并邀请带来一个使用鸦片剂的性伴侣， 家庭成员或亲密朋友（合作伙伴参与者），描述为属于 他们目前的个人注射吸毒网络进行采访。我们预计 268人中的一半将能够招募合作伙伴进行面试。的 最终的134名合作伙伴参与者将被随机分配到 干预条件（提供13周的免费美沙酮维持）或 控制条件（不提供免费治疗）。自我报告，尿液分析记录 在临床图表中，和其他生物指示剂数据（头发样本）将 在基线和随机化后4个月收集，以评估治疗 结果，艾滋病毒风险行为的变化，以及个人药物使用的变化 指数参与者及其指定参与者的网络特征 合作伙伴参与者。这项两组随机分配的试验性研究旨在 具体目标1：确定 为一名伴侣提供免费药物治疗将改善治疗效果， 减少指数参与者的艾滋病毒风险行为。具体目标2： 确定向合作伙伴提供免费药物治疗是否会导致 减少伴侣参与者的艾滋病毒风险行为和药物使用。具体 目标3：确定向一个伙伴提供免费药物治疗是否 显著改变个人吸毒的大小、密度和稳定性， 合作伙伴的网络，并最终引用索引。拟议 研究涉及一个实际的公共卫生问题，即在 美沙酮治疗往往是由亲密的朋友，家庭成员，或 重要的其他人。这项研究的总体目标是证明 治疗效果可以得到改善，艾滋病毒风险行为可以减少， 涉及至少两个网络成员同时进行药物治疗。

DESCRIPTION (provided by applicant): Methadone maintenance is an effective tool for reducing HIV risk and incidence among IDUs. All too often, however, individuals in methadone treatment continue to use opiates and other drugs, usually with a close friend or family member not currently enrolled in treatment. One response to this problem is to encourage at least one member of the methadone client's personal drug-using network to also enter treatment, thereby reducing the number of individuals presenting drug use opportunities. In this pilot study, 268 new methadone treatment entrants (Index Participants) will be interviewed and invited to bring in an opiate using sexual partner, family member, or close friend (Partner participants) described as belonging to their current personal injection drug-use network for interview. We anticipate that half of the 268 will be able to recruit a Partner for interview. The resulting 134 Partner participants will be randomly assigned to either the Intervention condition (offered 13 weeks of free methadone maintenance) or to a Control condition (no offer of free treatment). Self-report, urinalysis records in the clinical charts, and other biological indicator data (hair samples) will be collected at baseline and 4 months post-randomization to assess treatment outcomes, change in HIV risk behaviors, and change in personal drug-using network characteristics for both Index participants and their designated Partner participants. This two-group, random assignment pilot study is designed to address the following specific aims: Specific Aim 1: to determine if offering free drug treatment to one Partner will improve treatment outcomes and reduce HIV risk behaviors among Index participants. Specific Aim 2: to determine if offering free drug treatment to the Partner will result in reductions in Partner participant's HIV risk behaviors and drug use. Specific Aim 3: to determine if offering free drug treatment to one Partner will significantly alter the size, density, and stability of the personal drug-using network of the Partner, and ultimately of the referring Index. The proposed study addresses a practical public health problem, that ongoing drug use during methadone treatment tends to be initiated by close friends, family members, or significant others. The overall goal of the proposed study is to demonstrate that treatment outcomes can be improved and HIV risk behaviors reduced by involving at least two network members in drug treatment simultaneously.